Management of Complications of Dental Extractions - IneedCE.com

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surgery.” Evid. Based Dent. 2005. 6(1):10. 8. Moighadam, H., Caminiti, M. “Life-threatening hemorrhage after extraction of third molars. Case report and management protocol.” Journal of the Canadian Dental Association. 2002. 28: 670–674. 9. Neuper, E., Lee, J. et al. “Evaluation of dexamethasone for reduction of postsurgical sequelae of third molar removal.” J. Oral Maxillofacial Surgery. 1992. 50: 1177–1182. 10. Peterson, L., Ellis, E. et al. Contemporary Oral and Maxillofacial Surgery, 3rd ed. St. Louis, Mosby, 1998. 11. Pieluch, J., Arzadon, J. et al. “Prophylactic antibiotics for third molar surgery. A supporting opinion.” J. Oral Maxillofacial Surgery. 1995. 53: 53. 12. Pogrel, P. “The relationship of the lingual nerve to the mandibular third molar region.” J. Oral Maxillofacial Surgery. 1995. 53: 1178. 13. Robinson, P. “Observations on the recovery of sensation following inferior alveolar nerve injuries.” Br. J. Oral Maxillofacial Surgery. 1988. 26: 177. 14. Tiwana, P., Foy, S. et al. “The impact of intravenous corticosteroids with third-molar surgery in patients at high risk for delayed healthrelated quality of life and clinical recovery.” J. Oral Maxillofacial Surgery. 2005. 63(1): 55. 15. Wofford, D., Miller, R. “Prospective study of dysesthesia following odeontectomy of impacted third molars.” J. Oral Maxillofacial Surgery. 1987. 45: 15. 16. Zeitler, D. “Prophylactic antibiotics for third molar surgery. A dissenting opinion.” J. Oral Maxillofacial Surgery. 1995. 53: 61. Author Profiles Ian Woo, MS, DDS, MD Resident, Department of Oral and Maxillofacial Surgery, LAC+USC Medical Center, Los Angeles, CA, USA. Bach T Le, DDS, MD Assistant Professor, Department of Oral and Maxillofacial Surgery, LAC+USC Medical Center, Los Angeles, CA, USA. Disclaimer The authors of this course have no commercial ties with the sponsors or the providers of the unrestricted educational grant for this course. Reader Feedback We encourage your comments on this or any ADTS course. For your convenience, an online feedback form is available at www.ineedce.com. Online Completion Use this page to review the questions and answers. Return to www.ineedce.com and sign in. If you have not previously purchased the program select it from the “Online Courses” listing and complete the online purchase. Once purchased the exam will be added to your Archives page where a Take Exam link will be provided. Click on the “Take Exam” link, complete all the program questions and submit your answers. An immediate grade report will be provided and upon receiving a passing grade your “Verification Form” will be provided immediately for viewing and/or printing. Verification Forms can be viewed and/or printed anytime in the future by returning to the site, sign in and return to your Archives Page. Questions 1. When considering third-molar extractions, the _____ is an important factor. a. angle of impaction b. age of the patient c. mental status of the patient d. all of the above 2. According to the article, _____ is/are likely to increase the difficulty of extraction. a. brittle, supporting bone associated with prosthodontic treatment b. large restorations on nonadjacent teeth c. difficult root morphology d. local anesthesia 3. Post-operative bleeding from dental extraction can be due to _____. a. venous bleeding b. crevicular bleeding c. arterial bleeding d. a and c 4. Post-operative bleeding is _____ occurrence when performing third molar extractions. a. an unusual b. a frequent c. a desirable d. a and c 5. _____ can influence the difficulty of dental extractions. a. Trismus b. Tooth structures c. Tongue size d. all of the above 6. _____ is not listed by the authors as a patient factor in post-operative bleeding. a. Uncontrolled hypertension b. Vitamin-B deficiency c. Chemotherapeutic agents d. Liver disease 7. Patients who are on _____, amongst others, may have prolonged bleeding. a. aspirin b. Plavix c. chemotherapeutic agents d. all of the above 8. If an arterial bleeding source is identified, the authors recommend _____ as an initial treatment. a. applying firm pressure to the bleeding area and ligating the area with sutures b. instructing the patient to bite down on a gauze dressing c. electrocautery d. injecting epinephrine-containing anesthetics into the site 9. Post-operative bleeding following dental extraction normally lasts for _____. a. 4–6 minutes b. 7–9 minutes c. 10–12 minutes d. 15 minutes 10. If a source of bleeding is identified on the osseous structure, direct burnishing technique, using instruments such as a _____ may help close off the bleeding vessels. a. curette or hemostat b. curette or rongeur c. hemostat or forceps d. all of the above 11. If bleeding continues, use of _____ is recommended to achieve hemostasis. a. gelatin sponge b. oxidized regenerated cellulose c. collagen plug d. any of the above 6 www.ineedce.com
Questions (Continued) 12. Gelatin sponge _____. a. forms a matrix for clot stabilization b. is more efficient in hemostasis than oxidized regenerated cellulose c. is incompatible with topical thrombin d. stimulates platelet adherence 13. A collagen plug _____. a. stabilizes the clot b. stimulates platelet adherence c. is incompatible with topical anesthetics d. a and b 14. When conducting electrocautery, it is important to _____. a. first achieve adequate anesthesia b. avoid inadvertently burning adjacent tissues c. avoid burning the lips and tongue d. all of the above 15. _____ is symptomatic of hypotension. a. Dizziness b. Shortness of breath c. Pallor d. all of the above 16. Post-operative soft-tissue swelling _____. a. can be a normal part of the healing process b. is usually indicative of infection requiring antibiotics c. generally considered a cause for serious concern d. is almost always caused by patient health factors 17. _____ is one of the four cardinal signs of the inflammatory process. a. Tudor b. Rubor c. Dolor d. Calor 18. Granulation tissues _____. a. help bring nutrients to the wound for repair b. carry fibroblasts away from the wound c. form atop the wound’s initial clot d. none of the above 19. Post-operative surgical swelling can be expected to diminish from _____ days post-operatively. a. 3–4 b. 5–6 c. 7–8 d. 9–10 20. Post-operative surgical swelling can be expected to disappear after _______ post-operative days. a. two to four b. three to five c. six to eight d. seven to ten 21. _____ is not cited by the authors as a cause of nonsurgical post-operative swelling. a. Diabetes b. High cholesterol c. HIV-positive status d. Improperly sterilized instruments 22. When treating nonsurgical postoperative swelling, immediate referral to the emergency room is required if _____. a. the patient experiences shortness of breath b. the presence of multiple gram-positive cocci is confirmed c. drainage of the infective material is required d. gram-negative bacilli are causing chronic infection 23. The medical literature _____ the routine administration of prophylactic post-operative antibiotics for surgical dental extraction of wisdom teeth. a. does not support b. supports c. strongly supports d. none of the above 24. If antibiotics are to be used, the authors recommend a _____ dose to prevent wound infection. a. post-operative b. peri-operative c. mid-operative d. pre-operative 25. Dry socket is also known as _____. a. alveolar osteostosis b. alveolar osteitis c. crestal ostitis d. b and c 26. Dry socket _____. a. is proven to be caused by fibrinolysis b. occurs in 8 percent of all extractions c. is delayed wound healing after dental extraction d. is easily treated 27. Dry socket is not _____. a. delayed wound healing after dental extractions b. known as alveolar osteitis c. a cause of normal post-operative pain d. ever diagnosed until it is too late 28. Dry socket is usually diagnosed _____ days post-operatively. a. one to two b. two to four c. three to five d. four to seven 29. Initial management of a perforated sinus depends primarily on _____. a. patient compliance b. post-operative bleeding c. the size of the defect d. patient health factors 30. Small defects less than _____ should heal with no intervention. a. 2 mm b. 3 mm c. 4 mm d. 5 mm 31. Defects larger than 6mm require primary closure using a _____. a. buccal or palatal soft-tissue flap b. crestal flap c. gelatin sponge d. all of the above 32. The proximity of the roots of the mandibular third molar to the inferior alveolar nerve can be predicted by _____ as a radiological finding. a. lightening of the roots b. narrowing of the roots c. widening of the roots d. none of the above 33. The Seddon classification has _____ as one of the types of injury. a. neurotaxia b. axonotmesis c. ataxia d. all of the above 34. Neurotmesis involves the _____. a. loss of the relative continuity of the axon combined with the preservation of the encapsulated connective tissue framework of the nerve b. interruption in conduction of the neural impulse down the nerve fiber and subsequent recovery without Wallerian degeneration c. temporary loss of function, which is reversible within six to eight weeks d. loss of the relative continuity of both the axon and the encapsulated connective tissue 35. _____ is thought to be the mildest form of nerve injury. a. Neuropraxia b. Axonotmesis c. Neurotmesis d. Axonopraxia www.ineedce.com 7
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